alexa A structured autopsy-based audit of 370 firearm fatalities: Contribution to inform policy decisions and the probability of the injured arriving alive at a hospital and receiving definitive care.
Medicine

Medicine

Emergency Medicine: Open Access

Author(s): Papadopoulos IN, Kanakaris NK, Danias N, Sabanis D, Konstantudakis G,

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Abstract The objectives of this autopsy-based audit of firearm-related fatalities were to acquire data to inform policy decisions and to assess the probability of the injured arriving alive at a hospital and receiving definitive care. EVALUATED VARIABLES: Demographics; co-morbidities; location and intention of the injury; toxicology; types of firearms; Abbreviated Injury Scale; Injury Severity Score (ISS); transfer means and time; and location of death. RESULTS: Of a total of 370 fatalities, 85.7\% were male. The median age was 38 (9-95) years. Suicides (47\%) and assaults (45.1\%) were the most common underlying intentions. The most seriously injured regions were the head (44.5\%), thorax (25.7\%), abdomen (10.7\%), and spine (5.7\%). Of the 370 total subjects, 4.9\% had an ISS<16 and 59.5\% had an ISS≤74; both groups were classified as potentially preventable deaths. The majority (84\%) died at the scene, and only 9.8\% left the emergency department alive for further treatment. Multivariate analyses documented that postmortem ISS is an independent factor that predicts the probability of the injured reaching a hospital alive and receiving definitive care. Individuals injured in greater Athens and those most seriously injured in the face, abdomen or spine had significantly greater chances of reaching a hospital alive and receiving definitive care, whereas those injured by a shotgun and the positive toxicology group were significantly less likely to. In conclusion, this study provides data to inform policy decisions, calls for a surveillance network and establishes a baseline for estimating the probability regarding the location of firearm-related deaths. Copyright © 2012 Elsevier Ltd. All rights reserved. This article was published in Accid Anal Prev and referenced in Emergency Medicine: Open Access

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